Atrial Septal Defect Repair in Children—Transcatheter Procedure
by Rebecca J. Stahl, MA
An atrial septal defect is a hole in the wall between the two upper chambers (right and left atriums) of the heart. A transcatheter procedure is a minimally-invasive way to repair the hole. During this procedure, a device is implanted to seal the hole. As your child recovers, the device will trigger the heart tissue to grow. The tissue will slowly grow over the hole.
Reasons for Procedure
If a child is born with a hole between the upper chambers of the heart, the blood can flow backward into the right side of the heart and into the lungs. This triggers the heart to work harder. Over time, this can lead to damage to blood vessels in the lungs and congestive heart failure. The procedure is done to fix the hole.
Most children who have this procedure will have good outcomes.
Possible Complications TOP
Complications are rare, but no procedure is free of risk. Possible complications may include:
Some factors that may increase the risk of complications include:
Discuss these risks with the doctor before the surgery.
What to Expect TOP
Prior to Procedure
The doctor will do a physical exam of your child. Tests may include:
The doctor will tell you if you child needs to stop taking certain medicine. Ask the doctor when your child should stop eating or drinking before the surgery.
General anesthesia will be used. It will block any pain and keep your child asleep through the surgery. It is given through an IV in the hand or arm.
Description of the Procedure
Your child will receive IV fluid and medicines through a vein in his arm. The catheter (small tube) will be inserted either in the arm or groin. Next, electrodes will be placed on the chest. These electrodes will send information to the EKG machine, allowing the doctor to monitor the heart.
A catheter will be inserted in the blood vessel and advanced so the end is in the heart. Dye will be injected to allow the doctor to view x-ray images of the heart. An echocardiogram may also be used. Before the hole can be covered, the doctor will need to find out the size of the hole. A catheter with a balloon attached to it will be sent to the upper chambers of the heart. The balloon will inflate and measure the hole.
Once the doctor knows the size of the defect, another catheter will be sent to the heart. This catheter will have a device attached. There are different types of devices available. Some are able to open so that the hole is covered on both sides. Other devices open like an umbrella to cover the defect. Once the device is placed, the doctor will remove the catheter. Lastly, a bandage will be placed over the insertion site.
Immediately After Procedure
Your child will be closely monitored in the intensive care unit (ICU). The hospital staff will:
How Long Will It Take?
How Much Will It Hurt?
Your child will have pain and soreness. The doctor will give pain medicine.
Average Hospital Stay
The usual length of stay is 2-4 days. In some cases, your child may be able to go home as soon as the next day. The doctor may choose to keep your child longer if there are complications.
At the Hospital
When your child is recovering at the hospital, the hospital staff may:
When your child returns home, do the following:
Call Your Child’s Doctor If Any of the Following Occurs TOP
After your child leaves the hospital, call the doctor if any of the following occurs:
Call for Medical Help Right Away If Any of the Following Occurs
Call for medical help or go to the emergency room right away if any of the following occurs in your child:
In case of an emergency, call for medical help right away.
American Heart Association
National Library of Medicine
Heart and Stroke Foundation
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Last reviewed June 2012 by David N. Smith, MD
Last Updated: 6/4/2012